Individual provider Active NPI

William T. Prosser, CRNA

  • Certified Registered Nurse Anesthetist
  • Sacramento, CA
National Provider Identifier
1124004791
Registry record updated Nov 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
421995/2277 RN/CRNA Issued in CA
Practice address
4150 V St
PSSB-Suite 1200, Med: Anesthesia
Sacramento, CA 95817-1460
Phone
(916) 734-7985
Fax
(916) 734-2975
NPI assigned
Dec 15, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 421995/2277 RN/CRNA CA Primary

Addresses

Primary practice location

4150 V St
PSSB-Suite 1200, Med: Anesthesia
Sacramento, CA 95817-1460

Mailing address

4150 V St
PSSB-Suite 1200, Med: Anesthesia
Sacramento, CA 95817-1460
Phone (916) 734-7985

Other identifiers 1

IdentifierTypeStateIssuer
006406OtherCAPHYSICIAN INDEX #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, OR, WA, MT4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20050408001152 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 7012954217 Reassigns benefits to 1 organization
I20140319000781 OR Practitioner - Certified Registered Nurse Anesthetist (Crna) 7012954217 Reassigns benefits to 3 organizations
I20210208002902 WA Practitioner - Certified Registered Nurse Anesthetist (Crna) 7012954217 Reassigns benefits to 1 organization
I20211129000146 MT Practitioner - Certified Registered Nurse Anesthetist (Crna) 7012954217

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
421995/2277 RN/CRNACAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Associates Northwest LLC CurrentSince Feb 1, 2021 Accepting new patients
Northwest Medical Foundation of Tillamook Current Accepting new patients
Premier Anesthesia of Oregon PC CurrentSince Oct 1, 2024 Accepting new patients
Ascend Anesthesia Associates Mt LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 23, 2021 Accepting new patients
Anesthesia Services of San Joaquin, P.C. CurrentSince Mar 1, 2020 Accepting new patients
Northwest Medical Foundation of Tillamook CurrentSince Mar 4, 2022 Accepting new patients
Northwest Medical Foundation of Tillamook CurrentSince Mar 4, 2022 Accepting new patients

Locations

500 W Hospital Rd
French Camp, CA 95231
Phone (209) 468-6000

400 10th St E
Waconia, MN 55387

2440 Winne Ave
Ste 100
Helena, MT 59601
Phone (406) 452-4200

450 Mamaroneck Ave
Ste 201
Harrison, NY 10528
Phone (877) 476-6642

1001 N Providence Dr
Newberg, OR 97132
Phone (503) 216-1538

1500 Division St
Oregon City, OR 97045
Phone (503) 646-1631

120 NW 14th Ave
Ste 200
Portland, OR 97209
Phone (503) 771-1883

6400 SE Lake Rd
Ste 130
Portland, OR 97222
Phone (503) 594-1774

1000 3rd St
#M
Tillamook, OR 97141
Phone (503) 815-2260

1000 3rd St
Tillamook, OR 97141
Phone (503) 251-6129

8506 E Mill Plain Blvd
Ste C
Vancouver, WA 98664
Phone (360) 823-0880

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385078400000",
    "number": "1124004791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 V ST",
            "address_2": "PSSB-SUITE 1200, MED: ANESTHESIA",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958171460",
            "telephone_number": "916-734-7985",
            "fax_number": "916-734-2975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 V ST",
            "address_2": "PSSB-SUITE 1200, MED: ANESTHESIA",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958171460",
            "telephone_number": "916-734-7985",
            "fax_number": "916-734-2975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROSSER",
        "first_name": "WILLIAM",
        "middle_name": "T.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-15",
        "last_updated": "2013-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "421995/2277 RN/CRNA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN INDEX #",
            "identifier": "006406",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.